Chapter 1: Critical Thinking in Health Assessment

Question 1

After completing an initial assessment on a patient, the nurse has charted that his respirations are eupneic and his pulse is 58. This type of data would be:

a. objective.
b. reflective.
c. subjective.
d. introspective.

Answer 1

a. objective

Question 2

A patient tells the nurse that he is very nervous, that he is nauseated, and that he “feels hot.” This type of data would be:

a. objective.
b. reflective.
c. subjective.
d. introspective.

Answer 2

c. subjective

Question 3

The patient’s record, laboratory studies, objective data, and subjective data together form the:

a. database.
b. admitting data.
c. financial statement.
d. discharge summary.

Answer 3

a. database

Question 4

When listening to a patient’s breath sounds, the nurse is unsure about a sound that is heard. The nurse should:

a. notify the patient’s physician immediately.
b. document the sound exactly as it was heard.
c. validate the data by asking a co-worker to listen to the breath sounds.
d. assess again in 20 minutes to note whether the sound is still present.

Answer 4

c. Validate the data by asking a co-worker to listen to the breath sounds

Question 5

Novice nurses, without a background of skills and experience to draw from, are more likely to make their decisions using:

a. intuition.
b. a set of rules.
c. articles in journals.
d. advice from supervisors.

Answer 5

b. a set of rules

Question 6

Expert nurses learn to attend to a pattern of assessment data and act without consciously labelling it. This is referred to as:

a. intuition.
b. the nursing process.
c. clinical knowledge.
d. diagnostic reasoning.

Answer 6

a.

Question 7

Critical thinking in the expert nurse is greatly enhanced by opportunities to:

a. apply theory in real situations.
b. work with physicians to provide patient care.
c. follow physician orders in providing patient care.
d. develop nursing diagnoses for commonly occurring illnesses.

Answer 7

a.

Question 8

Which of the following is an example of a first-level priority problem?

a. A patient with postoperative pain
b. A newly diagnosed patient with diabetes who needs teaching about diabetes
c. An individual with a small laceration on the sole of the foot
d. An individual with shortness of breath and respiratory distress

Answer 8

d.

Question 9

Which of the following are considered second-level priority problems?

a. Low self-esteem
b. Lack of knowledge
c. Abnormal laboratory values
d. Severely abnormal vital signs

Answer 9

c.

Question 10

Which critical thinking skill helps the nurse recognize relationships among data?

a. Validation
b. Clustering-related cues
c. Identifying gaps in data
d. Distinguishing relevant from irrelevant

Answer 10

b.

Question 11

The nurse knows that developing appropriate nursing interventions for a patient relies on the appropriateness of the:

a. nursing diagnosis.
b. medical diagnosis.
c. admission diagnosis.
d. collaborative diagnosis.

Answer 11

a.

Question 12

Which five steps are included in the nursing process, which is a sequential method of problem solving?

a. Assessment, treatment, evaluation, discharge, follow-up
b. Admission, assessment, diagnosis, treatment, discharge planning
c. Admission, diagnosis, treatment, evaluation, discharge planning
d. Assessment, diagnosis, planning, implementation, evaluation

Answer 12

d.

Question 13

A newly admitted patient is in acute pain, has not been sleeping well lately, and is having difficulty breathing. How should the nurse prioritize these problems?

a. Breathing, pain, sleep
b. Breathing, sleep, pain
c. Sleep, breathing, pain
d. Sleep, pain, breathing

Answer 13

a.

Question 14

Which of the following would be formulated by a nurse using diagnostic reasoning?

a. Nursing diagnosis
b. Medical diagnosis
c. Diagnostic hypothesis
d. Diagnostic assessment

Answer 14

c.

Question 15

A nursing diagnosis made by a critical thinker using a dynamic nursing process would identify the actual problem and would also:

a. continue to reassess.
b. predict potential problems.
c. check the appropriateness of goals.
d. modify the diagnosis if necessary.

Answer 15

b.

Question 16

What is the step of the nursing process that includes data collection through health history taking, physical examination, and interview?

a. Planning
b. Diagnosis
c. Evaluation
d. Assessment

Answer 16

d.

Question 17

Which of the following statements illustrates the biomedical model of Western traditional views?

a. Health is viewed as the absence of disease.
b. Optimal health is viewed as high-level wellness.
c. Health and disease are considered parts of a cyclical process.
d. The treatment of disease is nursing’s primary focus.

Answer 17

a.

Question 18

The public’s concept of health has changed since the 1950s. Which of the following statements most accurately describes this change?

a. Lifestyle, personal habits, exercise, and nutrition are essential to health.
b. Assessment of health is critical to identifying disease-causing pathogens.
c. Accurate diagnosis and treatment by a physician are essential for all health care.
d. An individual is considered healthy when signs and symptoms of disease have been eliminated.

Answer 18

a.

Question 19

Why is the concept of prevention essential in describing health?

a. Disease can be prevented by treating the external environment.
b. The majority of deaths among Canadians under age 65 years is not preventable.
c. Prevention places emphasis on the link between health and personal behaviour.
d. The means to prevention is through treatment provided by primary health care practitioners.

Answer 19

c.

Question 20

Which of the following statements about nursing diagnoses is true? Nursing diagnoses:

a. evaluate the etiology of disease.
b. are a process based on medical diagnosis.
c. evaluate the response of the whole person to actual or potential health problems.
d. focus on the function and malfunction of a specific organ system in response to disease.

Answer 20

c.

Question 21

An example of objective information obtained during the physical assessment includes the patient’s:

a. history of allergies.
b. use of medications at home.
c. last menstrual period.
d. 2 × 5 cm scar present on the right forearm.

Answer 21

d.

Question 22

A visiting nurse is making an initial home visit to a patient who has a number of chronic medical problems. Which type of database is most appropriate to collect in this setting?

a. A follow-up database to evaluate changes at appropriate intervals
b. An episodic database because of the continuing, complex medical problems of this patient
c. A complete health database because of the nurse’s primary responsibility for monitoring the patient’s health
d. An emergency database because of the need to rapidly collect information and make accurate diagnoses

Answer 22

c.

Question 23

Which of the following situations is most appropriate for an episodic history?

a. A patient’s admission to a long-term care facility
b. A patient having sudden, severe shortness of breath
c. A patient’s admission to the hospital for surgery the following day
d. A patient having cold and flu-like symptoms and seen in an outpatient clinic

Answer 23

d.

Question 24

A patient is at the clinic to have her blood pressure checked. She has been coming to the clinic weekly since her medications were changed 2 months ago. The nurse should:

a. collect a follow-up database and then check the patient’s blood pressure.
b. ask the patient to read her health record and indicate any changes since her last visit.
c. check only the blood pressure because the patient’s complete health history was documented 2 months ago.
d. obtain a complete health history before checking the blood pressure because much of the patient’s information may have changed.

Answer 24

a.

Question 25

A patient is brought by ambulance to the emergency department with multiple injuries received in an automobile accident. He is alert and co-operative, but his injuries are quite severe. How should the nurse proceed with the data collection?

a. Collect history information first, perform the physical examination next, and institute life-saving measures.
b. Ask history questions while performing the examination and initiating life-saving measures.
c. Collect all information on the history form, including social support patterns, strengths, and coping patterns.
d. Perform life-saving measures and not ask any history questions until after the patient has been transferred to the intensive care unit.

Answer 25

b.

Question 26

Which of the following statements correctly describes age-specific charts for periodic health examination?

a. They are used to diagnose an illness.
b. They are helpful in identifying developmental delays in children.
c. They recommend that every individual receive an annual physical examination.
d. They list a frequency schedule for periodic health visits for a specific age group.

Answer 26

d.

Question 27

A 42-year-old patient of Asian descent is being seen at the clinic for an initial examination. The nurse knows that it is important to include cultural information in his health assessment to:

a. identify the cause of his illness.
b. make an accurate diagnosis.
c. provide cultural health rights for the individual.
d. provide culturally sensitive and appropriate care.

Answer 27

d.

Question 28

In the socioenvironmental model, the focus of the health care professional includes:

a. changing the patient’s perceptions of disease.
b. identification of biomedical model interventions.
c. identifying the negative health behaviours of the patient.
d. helping the patient view health as a resource.

Answer 28

d.

Question 29

Which of the following would be included in a holistic model of assessment?

a. Nursing goals for the patient
b. Anticipated growth and development patterns
c. A patient’s perception of his or her health status
d. The nurse’s perception of disease as related to this patient

Answer 29

c.

Question 30

When nursing diagnoses are being classified, which of the following would be considered a risk diagnosis?

a. Identifying existing levels of wellness
b. Evaluating previous problems and goals
c. Identifying potential problems the individual may develop
d. Focusing on strengths and reflecting an individual’s transition to higher levels of wellness

Answer 30

c.

Question 31

The nurse has implemented several planned interventions to address the nursing diagnosis of acute pain. Which of the following would be the next appropriate action?

a. Establishing priorities.
b. Identifying expected outcomes.
c. Evaluating the individual’s condition and comparing actual outcomes with expected outcomes.
d. Interpreting data, identifying clusters of cues, and making inferences.

Answer 31

c.

Question 32

Which of the following best describes a proficient nurse?

a. A nurse who has little experience with a specified population and uses rules to guide performance
b. A nurse who has an intuitive grasp of a clinical situation and quickly identifies the accurate solution
c. A nurse who sees actions in the context of daily plans for patients
d. A nurse who sees a patient’s situation as a whole, with long-term goals for the patient, rather than as a list of tasks to be performed

Answer 32

d.